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西非加速儿童生存和发展计划:一个回顾性评估
Jennifer Bryce1, Kate Gilroy, Gareth Jones
1Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. Jbryce@jhsph.edu
Lancet (London, England)
|January 15, 2010
概括
加快儿童生存和发展计划 (ACSD) 在贝宁和马里没有显著降低儿童死亡率.与其他地区相比,贝宁和马里没有显著降低儿童死亡率. 对疟疾和肺炎的干预措施没有得到有效实施,阻碍了儿童生存率的改善.
科学领域:
- 全球健康 全球健康
- 儿科健康 儿科健康
- 国际发展国际发展
背景情况:
- 联合国儿童基金会的加速儿童生存和发展计划 (ACSD) 旨在在11个西非国家将儿童死亡率降低25%.
- 在贝宁,加纳和马里进行了回顾性评估,以评估ACSD计划的影响.
研究的目的:
- 评估ACSD计划在减少儿童死亡率和改善儿童健康结果方面的有效性.
- 为了比较干预覆盖率,营养状况和ACSD重点地区与比较地区的死亡率的变化.
主要方法:
- 利用了来自人口和健康调查和多指标集群调查的数据.
- 在14个ACSD干预,营养状况 (衰退,衰减) 和ACSD和比较区之间的五岁以下死亡率中比较变化.
- 从分析中排除了主要的大都市地区.
主要成果:
- 在ACSD地区,儿童死亡率的减少在统计学上并不比贝宁和马里的比较地区更大.
- 在加纳和马里的ACSD地区,预防干预的覆盖率增加,但不是贝宁.
- 营养状况没有显著改善;针对常见的儿童疾病的治疗覆盖范围因国家和干预措施而异.
结论:
- 由于有效的治疗干预措施的加速不足以及未能解决新生儿死亡率和营养不良问题,ACSD计划未能加速贝宁和马里的儿童生存率.
- 昆虫杀虫剂处理网的库存短缺限制了该计划的潜在影响.
- 由于同时发生的政策变化和全国范围的计划加强,将加速效应归因于挑战.
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